(l-r) Holli Peters and critical care veterinarians Linda Martin
and Tandi Ngwenyama with Leah. Leah spent 56 hours on a
ventilator in the WSU Veterinary Teaching Hospital’s Small
Animal Intensive Care Unit.
For three days, “Leah,” a charcoal gray Cane Corso, or Italian Mastiff, with a white patch on her chest had not been breathing on her own. Hooked up to a ventilator in the intensive care unit of the WSU Veterinary Teaching Hospital, the machine delivered each breath to her weakened body. After so much time, her owner Holli Peters wasn’t sure Leah was going to pull through. “I thought about taking her off the ventilator, because her prognosis was not good,” she says. But on the fifth day, Leah started showing signs of improvement. She was starting to breathe on her own.
Two month earlier, in March 2015, Peters had read about Leah on a rescue group’s website. Covered with callouses, Leah had been found wandering outside a kill shelter in Houston, Texas. Part of her uterus hung outside her body and her nipples stretched two inches long from being bred too many times. Most likely she spent the first years of her life at a Texas puppy mill, and was left at the shelter when she could no longer have puppies. Her medical issues were so great that according to Peters even some rescue organizations didn’t want to take her. “I couldn’t stop thinking about her,” says Peters. “She deserved a chance.”
Leah made the trip from Texas to Montana, where Peters picked her up and drove her to her new home in Clarkston, Wash. Hontz, another rescued mastiff, was waiting for them. “When they met they became best friends,” she says. As the weeks went by, she noticed Leah seemed unusually tired and was sleeping more. Then Leah started having trouble breathing.
Peters took Leah to her local veterinarian who found a mass on Leah’s lung. Concerned it could be cancer, she was immediately referred to the WSU Veterinary Teaching Hospital. Once at WSU, Leah had a CT scan, which showed the mass to be the size of a tennis ball. Based on Leah’s age and the location of the tumor, WSU small animal surgeon Dr. Boel Fransson believed it was likely an abscess and not cancer, but she wouldn’t know for sure until she performed the surgery. Because Leah’s breathing was so labored Dr. Fransson recommended surgery right away.
The next morning on May 1, Dr. Fransson performed a lung lobectomy, removing Leah’s accessory lobe, one of four lobes dogs have in their right lung. After the surgery, Dr. Fransson was able to deliver the good news, the mass was not cancerous. And even with lobe removed, Leah would be able to easily have a normal life. Leah did so well post-surgery she was able to go home the next day. “She recovered really quickly from the procedure,” says Dr. Tandi Ngwenyama, WSU critical care veterinarian. “She is a really tough dog.”
But that night, Leah started coughing up blood. “She didn’t seem right,” said Peters. Leah was disoriented, breathing fast, and wouldn’t lie down. So Peters drove Leah back to the WSU veterinary hospital for emergency care. The diagnosis: aspiration pneumonia. “It is a common complication we see in the ICU,” says Ngwenyama.
Sometimes patients contract pneumonia, a secondary infection, post-surgery from being anesthetized or just from being sick and having inflammation, Ngwenyama says. Aspiration pneumonia is inflammation in the lung is caused by inhaling something foreign. In Leah’s case it is likely that she regurgitated and aspirated it into her lungs. If the gastrointestinal tract is not functioning properly, which is not uncommon during anesthesia, says Ngwenyama, a patient’s esophagus, which carries food from the mouth to the stomach, can have inflammation. Called esophagitis, it can cause the protective mechanism in the airway that usually prevents foreign substances from entering the lungs to be unable to do its job. The foreign matter doesn’t go all the way into the lungs, says Ngwenyama, but through aspiration into the airways it can cause a secondary infection such as pneumonia.
When Dr. Ngwenyama examined Leah, her lungs looked even worse than she expected. “Leah had a more severe infection and we suspected ARDS,” says Ngwenyama. Called Acute respiratory distress syndrome, ARDS can also be caused by aspiration. When a patient has ARDS, the lungs are unable to carry enough oxygen to the blood, and it is often life threatening. Ngwenyama says that similar to ARDS cases in people, the chance of a dog surviving ARDS is very low.
Because Leah’s lungs were unable to deliver the oxygen she needed, the WSU intensive care team began by giving her oxygen through tubing in her nose. But they could tell it wasn’t giving her enough oxygen, so they put her on a ventilator that would breathe for her. Patients like Leah need around the clock monitoring and care, says Ngwenyama. So a team of ICU nurses, veterinary residents, interns, and fourth year veterinary students took turns giving Leah 24-hour care.
While Leah was on the ventilator there were times both Ngwenyama and Peters wondered if they should continue. “There is no guarantee the patient will get better,” says Ngwenyama. “[The ventilator] just buys us time to let her body see if it can repair itself and recover from the pneumonia.” And because the ventilator may cause other complications, Ngwenyama wanted to take her off as soon as possible.
Just as they were losing hope, Leah started showing signs of improvement. Dr. Ngwenyama was able to decrease the amount of time Leah was on the ventilator and let her begin to breathe on her own. A few days later on May 12 she was strong enough to go home. “She surprised me,” says Peters. “No one thought she would pull through.”
“It can be a roller coaster ride, but Holli had a lot of faith and perseverance,” says Ngwenyama. “Against all odds Leah managed to overcome a lot of obstacles. She was able to get over pneumonia and walk out of the hospital.”
Two years ago, the WSU Veterinary Teaching Hospital expanded its emergency care service when they hired veterinarians and critical care specialists Drs. Tandi Ngwenyama and Linda Martin. “A few years ago without the current ICU team, Leah might not have lived,” says Dr. Fransson.
Leah returned to the hospital June 18 so Dr. Fransson could perform surgery to repair her uterus which in part had been hanging outside her body. The surgery went even better than expected and with no complications. “People teared up when they saw her looking like a normal dog again,” says Fransson. “It was very rewarding.” Two days later, Leah went home.
“I had nothing but a great experience at WSU,” she Peters. “It was really comforting having people care so much about her.”
For a dog whose life began with such hardship and cruelty, Leah now finds herself surrounded by love and support. Leah is enjoying her life with Peters and playing with Hontz. People from all over also gave generously* to help Leah, whose bills exceeded $23,000, and to the WSU intensive care unit.
When Leah returns to the WSU Veterinary Teaching Hospital for follow ups, everyone continues to dote on her. “She is like a celebrity when she comes in,” says Ngwenyama. “She is the sweetest, gentlest, and kindest dog. Not all of our patients make it in the ICU, so it is nice to see a success.”
*Leah received $1000 from the WSU Good Samaritan Fund.